Vitamin D and glucose metabolism in chronic kidney disease.
OBJECTIVE
Vitamin D deficiency has been linked with impaired glucose metabolism, an established risk factor for cardiovascular disease. Effects of vitamin D may be particularly important in chronic kidney disease, because vitamin D metabolism is substantially impaired in this setting. The present review examines the potential role of vitamin D in improving glucose metabolism and clinical health outcomes in chronic kidney disease.


RESULTS
Impaired glucose metabolism is common in chronic kidney disease. Short-term studies on maintenance hemodialysis patients have shown that vitamin D treatment improves insulin secretion and sensitivity. Intervention studies on people without end-stage renal disease have yielded mixed results. Mounting evidence from observational studies links vitamin D treatment with decreased mortality.


CONCLUSIONS
Vitamin D therapy holds promise for improving health outcomes in chronic kidney disease. Improved glucose metabolism is one potential mechanism through which vitamin D may exert beneficial effects. However, further data from clinical trials are needed to test whether vitamin D has clinically relevant long-term effects on glucose metabolism and overall clinical outcomes.
de Boer
Ian H
IH
Division of Nephrology, University of Washington, Seattle, Washington 98195, USA. deboer@u.washington.edu
D000818:Animals; D002908:Chronic Disease; D005947:Glucose / Q000378:metabolism*; D018149:Glucose Intolerance / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D016896:Treatment Outcome; D014807:Vitamin D / Q000378:metabolism* / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*
D014807:Vitamin D; D005947:Glucose